text:
|Bed status information system for hospital beds
|Ulrich et al.
|Identification card and access control device
|Keskin et al.
|Method for managing data transfer between computing devices
|Landis et al.
|Method of handling data retrieval requests
|Landis et al.
|File based and highly available hybrid database
|Carter et al.
|Workflow server for medical records imaging and tracking system
|All care health management system
|Cummings, Jr.
|Method and apparatus for accessing a portable personal database as for a hospital environment
|Method and apparatus for distribution of movies
|Ballantyne et al.
|Medical information system with automatic updating of task list in response to charting interventions on task list window into an associated form
|Brimm et al.
|System and method for scheduling and reporting patient related services including prioritizing services
|Patient identification and verification system and method
|Gombrich et al.
|Patient care system
|Gombrich et al.
This is a continuation-in-part application of U.S. patent application Ser. No. 08/241,405 filed May 11, 1994 now abandoned.
(a) a data source in the form of a Master Library (ML) storing data in digital compressed format, the ML being adapted to store unprocessed or digitally compressed data selected from one or more of the following:
(i) patient/medical staff health record information,
(ii) clinical data including X-Ray, MRI and video images,
(iii) patient laboratory data to support medical diagnoses and investigations,
(iv) educational/training information in video or textual format for the training of medical personnel and patient requirements,
(v) pharmaceutical databases,
(vi) entertainment audio/video data,
(vii) monitored video of critical areas including operating rooms and psychiatric wards,
(viii) general security video monitoring data, and
(ix) management information data including accounting/billing and inventory control/ordering services;
(b) a communications interconnection system electronically associated with the ML;
(c) a computerized nursing station electronically associated with the ML through the internal medical information network for temporary storage of patients' health records that have been accessed and downloaded from the ML, said nursing station operating as a client/server computer system, wherein the server computer is part of the nursing station and the client systems are the interconnected Patient Care Stations (PCS). The nursing station server system containing disk and random access memory (RAM) and the server computer to temporarily store health records for patients interfaced to this station;
(d) an electronic PCS comprising client computers located at each patient bedside communicating with the nursing station server system, said client computers each comprising a central processing unit with associated memory and the following items:
(i) a monitor screen for display of normal NTSC video, RGB video and other interfaced/non-interlaced digital video formats;
(ii) interface means to electronically communicate through the communications interconnection system with the ML and with the nursing station;
(iii) a wireless/IR transmitter/receiver to communicate with a pen based computer device (Personal Data Assistant or PDA);
(iv) an input entry device to facilitate the patient/medical staff communication within the system;
(v) compression and decompression means for data passed to and from the patient care station; and
(vi) application software supplying patient and medical staff services.
(a) physicians offices;
(b) clinics and laboratories;
(c) video entertainment libraries;
(d) electronic medical libraries;
(e) hospital security, patient and operating room monitoring information
(f) patient's residences.
(a) meal selection,
(b) selection of electronic entertainment and information packages selected from the group comprising regular TV programming, movie videos on demand, video games, educational information, clinical data and administrative data;
(c) and third party oriented services selected from the group comprising florist, giftshop, chaplain, physiotherapist.
The present invention relates to a method and apparatus for distribution and administration of medical services, entertainment services, electronic health records, and educational information useful in hospitals, other types of health care facilities, and patients' homes. Presently, some hospitals are automated only to the extent of storing basic patient information, such as patient's name and address, admitting doctor, type of ailment, etc., electronically in computer memory, to be accessed by administrative staff or, at nursing stations, by nurses or other medical personnel. Otherwise, much patient information is collected manually and stored on pages in the patient's file. Of interest to the present invention is our U.S. Pat. No. 5,133,079 entitled an apparatus for the distribution of movies, in which entertainment services, in the form of movies or the like, are delivered electronically in digitally compressed form from a master library to the home or other location of a customer.
Of general background interest to the present invention are the following references, namely Brimm, et al U.S. Pat. No. 5,077,666 (December, 1991) which describes and illustrates the data entry system intended for intensive care, with two display units at each bedside, connected to patient monitoring equipment, which system provides a file server with limited computer functions and some associated disk storage; Cummings, Jr. U.S. Pat. No. 5,301,105 (April, 1994) which teaches a system for health care for patients including a method of payment for billing and a card, personal to a patient, for simple personal identification using magnetic stripe technology; Garcia U.S. Pat. No. 5,065,315 which describes and illustrates a system and method for re-scheduling and reporting patient related services in a hospital, centered on editing procedures and information for a patient and entering information pertinent to a patient's stay in a hospital, including scheduling for tests; Wilhelm U.S. Pat. No. 5,319,543 (June, 1994) directed to a system for central processing of medical records and management of work flow associated with the storing and tracking of electronic medical records based on PC workstations located at nursing stations or physician's offices and Chaco U.S. Pat. No. 5,291,399 (March, 1994) which teaches a system which distributes and processes medical information, optionally by keyboard data entry at a patient's bedside.
An object of the present invention is to provide a more automated system for distribution and administration of medical services, entertainment services, electronic health records and the like for hospitals, other health care facilities, including the patient's bedside in a hospital or at the patient's domestic premises.
In accordance with the present invention there is provided an electronic information system for distribution of medical information and patient services which comprises:
(a) a data source in the form of a master library storing data in digital compressed format;
(b) a communications interconnection system electronically associated with the master library;
(c) an automated nursing station electronically associated with the master library through the communications interconnection system for temporary storage of a patient's health records, comprising computer means incorporating a client/server configuration and sufficient memory to temporarily store health records for patients monitored by this station;
(d) an electronic patient care station comprising:
(i) a monitor screen for display of normal NTSC video, RGB video and other interfaced/non-interlaced digital video formats;
(ii) interface means to electronically communicate through the communications interconnection system with the master library and with the nursing station;
(iii) a wireless/IR transmitter/receiver to communicate with a pen based computer device;
(iv) an input entry device to facilitate the patient/medical staff communication within the system; and
(v) compression and decompression means for data passed to and from the patient care station.
In a preferred embodiment of the present invention, the system comprises a plurality of nursing stations and one or more patient care stations which are electronically associated with each of the nursing stations. It is preferred that the master library be adapted to store data preferably in digital compressed form selected from one or more of the following:
(a) patient/medical staff health record information,
(b) clinical data including X-Ray, MRI and video images,
(c) patient laboratory data to support medical diagnoses and investigations,
(d) educational/training information in video or textual format for the training of medical personnel and patient requirements,
(e) pharmaceutical databases,
(f) entertainment audio/video data,
(g) monitored video of critical areas including operating rooms and psychiatric wards,
(h) general security video monitoring data, and
(i) management information data including accounting, billing and inventory control/ordering services.
As well, the master library is preferably provided with means to receive and store, in digitally compressed form, data from one or more of the following:
(a) physicians' offices;
(b) clinics and laboratories;
(c) video entertainment libraries;
(d) electronic medical libraries;
(e) hospital security, patient and operating room monitoring information; and
(f) patients' residences.
Through the use of such an electronic information system, many record keeping operations of a typical hospital can be rendered paperless. As well, the collection and distribution of information in the hospital relating to patients, and the delivery of services to patients, as well as many other aspects of hospital administration are significantly facilitated through the use of the system according to the present invention, resulting in enhanced healthcare quality.
These and other objects and advantages of the invention will become apparent upon reading the following detailed description and upon referring to the drawings in which:
FIG. 1 is a schematic block diagram of a system for distribution of medical information and patient services in a hospital or other such health care institutions, physicians' offices and patients' residences, in accordance with the present invention;
FIG. 2 is a schematic block diagram of an example embodiment of a configuration of the master library of FIG. 1;
FIG. 3 is a schematic block diagram of an example embodiment of systems software architecture of the system of FIG. 1;
FIG. 4 is a schematic diagram of the apparatus and its manner interconnection to the other components of this system, of an example embodiment of the patient care station of FIG. 1;
FIG. 5 is a schematic block diagram of the internal configuration of the patient care station of FIG. 4;
FIG. 6 is a schematic view of an example embodiment of a system for patient information input, as well as access and retrieval of that information, in accordance with the present invention;
FIGS. 7A and 7B are schematic views of an example embodiment of a configuration of the regional library of FIG. 1;
FIGS. 8A and 8B are flow charts describing the process in assigning channels on the internal medical information network to the various services offered to the patients and the medical personnel;
FIGS. 9A, 9B and 9C represent a flow chart depicting the access control and user verification and authentication process that occurs when an individual attempts to gain access to the electronic medical record repository;
FIGS. 10A, 10B, 10C, 10D and 10E represent a flow chart that depicts the process a user (patient or medical staff) would perform in selecting various services from the internal medical information network;
FIGS. 11A, 11B, 11C, and 11D represent a flow chart that details the process medical personnel would perform in the administration of health care;
FIGS. 12A and 12B represent a flow chart that describes the identification and verification process that occurs when medical personnel initially attempt to gain access to the internal medical information network for the use of and modification to patient's electronic medical records.
While the invention will be described in conjunction with illustrated embodiments, it will be understood that it is not intended to limit the invention to such embodiments. On the contrary, it is intended to cover all alternatives, modifications and equivalents as may be included within the spirit and scope of the invention as defined by the appended claims.
In the drawings, similar features have been given similar reference numerals.
The medical information network according to the present invention consists of all the related hardware and software components of a master library (ML) (2), a communications interconnection system (4), the distributed processing nursing stations (6), individual bedside patient care stations (PCS) (8), and integrated personal data assistants (PDA) (10). FIG. 1 is a schematic block diagram of the overall system.
The ML, situated locally within the physical boundary of each hospital or by geographical regions serving several hospitals, is configured as a client/server system.
It acts as a medical data depository for all text, audio, and video material including text, graphics, still images, full motion video, and sound/audio information. It includes the storage and processing capabilities to satisfy all administration, medical staff, and patient service requirements. Data is stored in compressed digital format, using typical data compression techniques for text and video image information to minimize memory storage and to facilitate the transmission of data to interconnected user/patient locations. These compression algorithms consist of those listed as follows but are not necessarily limited to those identified:
Run-length encoding
Huffman encoding
Arithmetic coding
String matching techniques
LZ-77 and 78 algorithms
Video--MPEG I and II standards
JPEG standard
Digital Video Interactive (DVI)
Audio Video Interleaved (AVI)
Vector Quantization (VQ)
The types of data stored in this master library include, but not limited to:
(a) all patient/medical staff health record information,
(b) all clinical data including such items as X-Ray, MRI video images, etc.
(c) all patient laboratory data to support medical diagnosis and investigations,
(d) educational/training information in video and/or textual format for the training of medical personnel and patient requirements,
(e) pharmaceutical databases,
(f) entertainment audio/video data,
(g) monitored video of critical areas including operating rooms, psychiatric wards, etc.,
(h) general security video monitoring data, and
(i) management information data including account/billing and inventory control/ordering services.
For the distribution of video entertainment information the concept described in Ballantyne, et al U.S. Pat. No. 5,133,079 "Method and Apparatus for the Distribution of Movies" is incorporated in this system.
The ML is configured as a client/server computer system to implement the storage and processing of the previously identified items (refer to FIG. 2). The ML consists of various computer servers with each server dedicated to a specific function i.e. a video server (34)for the distribution of video services for patient movie demands, educational/training videos, etc. This video server is based on the technologies available from DEC, Silicon Graphics, N-Cube or ATT/NCR. To facilitate the compression of data, whether text or audio/video data, a compression server system (36) is available. This server system uses compression hardware and software from suppliers such as Optibase, FAST, Xing, etc. to implement data compression to MPEG and JPEG standards. These computer servers are interconnected for administration purposes and general overall data communications via a Local Area Network (22) configured as a fast Ethernet topology and a high speed data bus for the connection to local mass disk storage (28) and RAM memory (30). This high speed bus (24) is based on High-Speed Serial Interface (HSSI), or High-Performance Parallel Interface (HiPPI), or Fiber Distributed Data Interface (FDDI) standards, or other standards that facilitate the rapid distribution of data. These internal networks are interfaced with the Hospital information network through the communications controller (26). This controller is responsible for network channel control, the multiplexing and demultiplexing of data, signal modulation/demodulation, and all data routing between the internal ML network and the Hospital information network. Typical communication controllers conducting these functions are available from vendors such as Scientific Atlanta. Overall communication coordination is effected through the communications server computer (38). Network channels are assigned in accordance with the service being provided, a channel being 6 MHz of bandwidth, equivalent to an analog CATV channel. It is assumed that the internal communications network has a capacity of 750 MHz. of bandwidth (125 channel capacity) whose breakdown is further described in the description of the communications infrastructure. Refer to FIGS. 8A and 8B for the process performed by the communications server in the assignment of the various service channels. These Figures describe the process in assigning channels on the internal medical information network to the various services offered to the patients and the medical personnel. If the service is simple analog cable programming supplied by the local cable companies it is assigned a dedicated channel as it would appear in local TV guides. This ensures a one-to-one correspondence and facilitates patient usage. The first channels (up to channel 70 inclusive) on the network are dedicated to this CATV programming (300). There will be considerable variety in this assignment from geographic region to region but it has been assumed that this first bank of channels is more than adequate to accommodate this variation. The next section of bandwidth (channels 75 to 80) has been allocated to the distribution of Video-On-Demand (VOD) services (302). These VOD services are supplied by the video server existing in the ML. Included in these services are requests for video movies, music videos, and video games. Channels 71 to 74 are used for the distribution of educational and training video material information (304). This material is also maintained in the video server of the ML and can be distributed to all users i.e. broadcast mode or uniquely to individual users. Patients can request training material such as information for new mothers on the correct procedures for the feeding and bathing of newborns or nursing staff can view educational data on new pharmaceuticals and the correct procedures in their administration. The next 15 channels (81 to 95) have been assigned as Hospital security channels (306). More and more video camera security monitoring is being conducted for insurance liability purposes. The video information is compressed at the camera source and stored in a file server at the ML. If more then 15 cameras are to be monitored, time division multiplexing of the data is implemented to accommodate the additional video streams (the Rapid Eye software product from AIT Corporation is to be used to facilitate this security monitoring capability). Specific areas of the hospital, for medical reasons, could require 24 hour video monitoring. This occurs in areas including psychiatric wards where nursing staff observe patients from the nursing stations without actually visiting the patient's premises and also in critical sections such as operating rooms for physician usage and liability issues. The five channels from 96 to 100 are assigned to this dedicated monitoring service (308). The next 10 channels are assigned in order to individual nursing station locations. Each of these channels are dedicated to the distribution of patient electronic medical records (310) with each nursing station temporarily storing the records of the patients that are assigned to the care of that nursing station. The number of nursing station channels (312,314) will vary in accordance with the size of the hospital and thus the number of nursing stations in place. There is sufficient capacity in the network to add extra channels if more nursing stations exist (in the present configuration there are 10 spare channels available). Patient laboratory data (316) is distributed to the nursing stations and the ML over the next 5 channels (from 111 to 115) whereas patient telephony (318) (bedside phone calls) are confined to the back haul channels in the low frequency bandwidth region. Because of the uniqueness of the operations of individual hospitals, the data networking architecture of each hospital will be customized accordingly.
The memory storage media consists of dedicated or combinations thereof of memory devices including optical juke boxes, magnetic memory, magneto or electro-optical memory (28), high speed solid state memory (30), high density tape, etc. to be utilized in accordance with the specific application. Mass memory storage components such as the Ampex DST (32) and Sony's CD-ROM storage systems are typical technologies that satisfy this ML storage requirement. Dedicated text scanning units and imaging systems (40) (Xerox) are integrated with the ML to facilitate the scanning of documents and image material existing in hard copy format.
The ML is interconnected to distributed user sites (i.e. nursing stations and patient bedside units) within the confines of the hospital through an interactive two-way fiber optic cable, coaxial cable, and/or twisted pair cabling (42). The preferred embodiment is a hybrid fiber coax (HFC) configuration. This HFC network provides a downstream (to the patient bedside) frequency bandwidth of 50 to 750 MHz. with an integrated upstream (from the patient's bedside) frequency bandwidth of 5 to 30 MHz. These distributed users can be stand alone dedicated processors (at the bedside) and/or distributed system processors such as those located at the nursing stations. The use of wireless technology is utilized in areas where it is difficult to install suitable cabling or simply areas where wireless communications are more economical.
The ML is linked to external sources via Direct Broadcast Satellite (DBS) equipment, to receive or transmit relevant information. It is also linked to external clinics, other hospitals, medical schools, general practitioner's offices, and patients' residences through landline communications (twisted pair, coaxial cabling, fiber optic cable), DBS or wireless communications (44). A multimedia electronic mail system is implemented amongst authorized users. This facilitates the interaction between external users and the ML i.e. a general practitioner wants to inquire on the latest health care status of one of his/her patients.
The ML is also responsible for implementing voice switched telephony (46), communications between the patient's bedside telephone and the public telephone network. This capability is implemented through the upstream channel available on the HFC network which allows the multiplexing of data, video, and voice over a common integrated fiber/coaxial cable. The technology to facilitate this integration of telephony onto a fiber-coaxial network is available from vendors such as Scientific Atlanta. The appropriate billing and accounting software to monitor patient usage is inherent in this equipment. If the patient telephony communications is implemented via wireless means through equipment such as using Ericsson's Freeset system, the voice switched processor becomes the Freeset's radio exchange connected to an external PBX or Centrex unit.
The entire ML and associated medical information network is based on an open client/server computing environment whose systems software architecture is based on Windows NT, or a similar capable Operating System (OS). In this open OS environment the "client" is able to use any vendor application software and the OS provides the appropriate resource "server" to satisfy the user requirement. As a result, it is easy to add or change server functions for they do not depend directly with the selected server hardware. A typical open client/server configuration is depicted in FIG. 3. The overall system applications include management information services, accounting/billing services, inventory control, medical data retrieval, health record retrieval and entry, etc. The system software, residing over an information database, provides a full data storage, search and retrieval capability (as in Fulcrum's SearchTools utility) where every word is a keyword, and thus every word can be searched. This is significantly different from typical keyword searching that only allows specific terms and fields to be set-up as searchable. The following features are inherent in the storage, search and retrieval system:
(1) the system is fully compatible across an array of hardware platforms. This ensures that the distributed nursing stations easily interface, without having to re-process the stored data, with the larger more complex ML.
(2) large data collections normally have complex search requirements which can be wieldy and impractical. In order to facilitate data searches and retrievals of large data collections, the proposed system indexes the data. The index files are then used to support the complex searches, and only those documents that satisfy the search criteria are retrieved.
(3) multiple sources or collections of data can be simultaneously searched. However, identical documents or health records can be maintained in different collections i.e. infants under the age of 5 years, children with digestive disorders that include colic infants--these two data collections would contain similar health records.
(4) comprehensive and thorough search capabilities including logical Boolean searches (AND, OR, and NOT), single words, phrases, multiple words in proximity, etc.
(5) advanced search features such as term weighting (some search terms are more relevant than others), relevance ranking where the search results are ordered in accordance to their importance, intuitive searching where the search is performed on a similarity to a portion of text or document, etc.
(6) maintain and keep search lists to audit previous searches and allow simple modifications to implement a new search query.
(7) support searches on structured and unstructured text, multilingual text, and embedded images.
(8) support searches on native formatted documents such as word processed data i.e. Word Perfect file format.
(9) allow the customization of user interfaces to satisfy unique data entry requirements.
The complete ML is implemented within an unique security architecture (48). The security process is based on the identification and authentication of individuals requesting access to the health record database. This access can be requested internally or from external sources. Access is only granted to authorized users of which the library software automatically audits all users' accesses. Patients request or are sent a monthly statement illustrating who has had access to their health records. Various levels of security access are applied to different sections of the individual's health record i.e. psychiatric data can not be accessed by the general practitioner. The other aspect of the security shell deals with the data compression technology. Depending on the format of the data, different compression algorithms are used. This forms another level of security for without the correct decompression algorithm to undo the original compression operation, the data remains unusable. FIGS. 9A, 9B, and 9C illustrate the security screening access process that is implemented when a new user attempts to gain access (320) to the ML and the medical information network. Initially, each potential user of the network has completed a questionnaire that identifies who they are and specific demographics about them. Once successfully completed, an unique identification number (ID) is assigned to each user and their personal profile data is stored electronically online. Users are subdivided into specific categories relative to their qualifications, their professional status, and their necessity to gain access to medical information and/or the medical information network i.e. physicians as compared to nursing staff, ambulance personnel as compared to medical staff, surgeons as compared to psychiatrists, etc. To gain access to the medical information network, each user first enters their ID number (322). This ID number is then validated (324) with a central user list to confirm they are a legitimate user. If a match does not occur they are immediately denied system access (326). However, if a match is determined, the users personal electronic profile is accessed (328). The system then queries (330) the user with a specific question (332) i.e. What was your mother's name? If the user answers correctly (334), access to the network is granted (336) and the time of access is logged (344). This completes the user identification and authentication process. However, for each access attempt the user makes, the authentication query changes based on the information in the user's personal electronic profile. The validated user is now allowed to access the patient's electronic medical record. Depending on the category classification of user's ID number as previously discussed, general access (338) to the patient's record is granted or a further Personal Identification Number (PIN) is requested (340). This would occur in the situation where a patient's general practitioner would like to review the patient record to determine the latest status and would not have access to sensitive psychiatric data within the patient's record. This area could only further be accessed upon entry of another user's number (342) i.e. psychiatrist's unique PIN. As well as logging the access time of each user on the network, each patient record has its own audit trail. All authorised users that access any patient record, their name and time of access are all documented (344). The patient has the right to request an access log (346) for their personal medical record or the system can initiate a timely print out (348) of all active personal medical records which is forwarded to patient for review. When the authorised user has completed their requirement for accessing the medical network, a standard exit log-off procedure (350) is initiated If for any reason the user forgets to log-off the network, their access is automatically terminated after a duration of 12 hours.
Patient Care Station (PCS)
The PCS facilitates the interaction between the patient and ML services or between the medical staff and the ML. Each PCS has an unique addressable identification code ensuring a one-to-one correspondence between the patient's location and the ML. The PCS has five main components (refer to FIG. 4): a monitor (50) that can display normal NTSC video, RGB video, or any other interlaced/non-interlaced digital video formats; an interface unit (52) to communicate with the medical information network; a Personal Computer Memory Card International Association (PCMCIA) reader/writer (54) or an equivalent smart card reader/writer technology; a wireless or Infra Red (IR) transmitter/receiver (56) to communicate with a Personal Data Assistant (PDA) such as those from NEC, AT&T, Apple, IBM, Fujitsu, etc.; and an input entry device (58) to facilitate patient/medical staff communication with the system (this entry device is either a remote or separate device or an integral component of the monitor).
Its operations are based around a user menu/submenu graphical interface which selects the desired/requested operation. Menu interaction is either effected through a touch screen on the monitor or through the remote interactive control device. Depending on the user, various menu formats are implemented. For the patient, a large graphical image is effected to facilitate the identification and selection of the requested service. For medical staff/physicians, a more detailed "Window" type menu is available to enable the selection of more detailed medical forms and services. The input entry devices, for these two types of users, are also different. For the patient, a simple numerical entry (the pressing of a single digit key button) to select the requested service would suffice, whereas the medical staff has a more sophisticated entry device to allow alpha-numeric data and features such as scrolling, cursor movement, etc. to be implemented. The interactive capability of the PCS allows the patient to order/select various services including meal selection, selection of a variety of entertainment packages including regular TV programming, movie videos on demand, video games, educational information, clinical data that the patient has been allowed to access, administrative information such as medical charges, and third party oriented services including those of the florist, chaplain, physiotherapists, etc. The data is transferred to and from the PCS in compressed digital format to minimize data loading on the network and then decompressed at the bedside when used. The decompression is accomplished via two means; the decompression algorithms are resident in the PCS such as the MPEG decompression technique for movie videos or the unique decompression algorithm is transmitted with the data file when transferred to the user. This is the situation when specific lossless compression techniques are used in the processing of medical files relating to high resolution images i.e. MRI or X-ray video data. FIGS. 10A, 10B, 10C, 10D and 10E represent a flow chart that depicts the process a user (patient or medical staff) would perform in selecting various services (352) from the internal medical information network. The PCS and its associated monitor/TV, when in the idle mode, displays on the screen a simplistic graphical interface which categorizes the user as a "patient" or as "medical personnel". When the user is classified as a patient (354), a sub-menu appears identifying all the services (356) that are available at the bedside. These include the following specialities (though not limited to), which are selected by a simple numeric designation:
1) Entertainment (358)--further subdivided into
a) cable TV programming (360)--channel selection
b) video on demand movies (362)
c) interactive games (364)
d) electronic media including newspapers, magazines, etc. (366)
2) Food/Dietary menu (368)
3) Educational/Training information (data and video material) (370)
4) Personal Patient information (372)
5) Third Party Services (374)--further subdivided into
a) chaplain visit requests (376)
b) florists, tuck shop, convenience store, etc. (378)
c) medical services such as physiotherapy (380)
6) Additional Services (382)--custom requirements
If the user has been classified as "medical personnel ", they initially enter their unique ID number to further classify them as nursing staff, or practising physicians. If nursing staff (384), the patient record information is retrieved from the appropriate nursing station and the associated patient charts and data entry forms are displayed (386). The correct information is then entered i.e. temperature, blood pressure, medication administered, etc. and then the patient's medical record is updated (388). If the user has been identified as a physician (390) then the entire medical record (392) is made available for viewing at the bedside through the PCS. The physician then enters their personal notes, observations, etc. (394) and the patient's medical record is modified accordingly. It should be noted that no mention has been made as to the specifics of the data entry device: this can either be accomplished directly through a touch panel on the display or through a personal data assistant as will be discussed subsequently.
With reference to FIG. 5, for the preferred HFC cable implementation of the medical information network, normal CATV signals are received by the PCS through the CATV tuner/convertor (60) and routed directly to the monitor for display. Control of the CATV tuner is performed by the CPU (62) that has received its instructions (i.e. channel selection) from the input entry device interface (64). This input entry device interface unit is either an integral part of the monitor such as a touch screen or a separate component of the PCS as previously described. The CPU is also connected to an internal bus (66) that handles data transfer and control/status signals which links internal memory (68), a graphics/decompression processor (70), the wireless transmitter/receiver for the PDA interface (72), and the PCMCIA reader/writer unit (74). A complementary RF tuner/converter (76) exists for the Video On Demand (VOD) requests. The CPU controls the channel and movie selection of the VOD tuner which routes the data to the demodulator (78) to restore the original digital data stream. A specific memory controller (80) is used to control the data (compressed video information) passed to the high speed memory device (82) that is either magnetic, optical, (or combinations thereof), or solid state (includes flash card memory) depending on the amount of data transmitted. Upon playback, the compressed data is first decompressed by the decompression unit (70) and than processed by the D/A converter (84) and analog processor (86), depending on the video format to be displayed, and passed to the monitor (90) through the video switch (88). The audio (stereo) is processed by a separate processor (92) fed directly from the decompression unit.
The health card reader and/or writer that is a major component of the PCS is based on smart card technology. This reader/writer supports various configurations of smart card technology be they based on solid state memory and microcontrollers (Hitachi, Motorola, SGS-Thomson, Bull, Catalyst, etc.), optical memory (Drexler, Canon), or combinations of the aforementioned. The standardized PCMCIA card slots are utilized. These cards are used to maintain an electronic health record or other user information in digitally compressed format on each patient. These cards are appropriately modified and updated as health care is administered. The health card, by default, allows the network to track the location of the patient through the unique address ID of the bedside PCS and the uniqueness of the patient's health card. Therefore the system always knows the exact location of each patient at all times even if the patient is moved, for as soon as the patient's health card is inserted in the smart card slot of another PCS, the network registers this initialization automatically. As long as the patient is at this bed location, their health card remains inserted in the associated bedside PCS.
Because the PCS utilizes a coaxial cable interface, the PCS can be located at the residence of the patient. This facilitates the out-sourcing of health care to external health care service providers. The PCS receives from the ML post recovery rehabilitation information in the form of video and text data, special dietary/nutrition instructional data, physical rehabilitation programming, etc. The PCS also interfaces with specific external health care monitoring equipment to register and track certain patient characteristics as temperature, pulse rate, etc., then pre-processes the data, and transmits the results back to the ML. Video monitoring of the patient's condition is also facilitated through the addition of a remote small video camera. By means of a PDA carried by an external care giver, detailed health record information is accessed from the ML and modified with up-to-date medical diagnostic data.
The monitor is either that of a Cathode Ray Tube (CRT), Liquid Crystal Display (LCD), or newer technologies such the diamond-based video and computer display panels. The display is either interlaced or non-interlaced depending on the display technology used. The monitor, as a preferred configuration, will have the hardware functionality and associated resident software in the display driver to facilitate Display Power Management Signalling (DPMS). This feature has the capability to place the monitor into four different power states: on, standby, suspend, and off, depending on the activity of the PCS. This will result in significant energy savings, especially during periods of relative inactivity, where the monitor is placed in an efficient power mode.
Several options exist with respect to the PCS. Additional PCMCIA slots can be added to facilitate features such as FAX/modems, expanded memory requirements, special interfaces to local area network systems i.e. DEC Ethernet, etc. The PCS can also be equipped with a simple magnetic stripe card reader and/or writer to accommodate other types of health cards. Voice recognition software/hardware (such as the technology available from Kurzwell) can be added to facilitate the entry of health record information via voice. Included in this feature would be the use of an individual personality PCMCIA card, to customize the voice recognition software to the individual's unique voice attributes. This eliminates the need to train the voice recognition software which could take a sufficient length of time and likely lead to significant errors during this training period.
Computerized Nursing Stations
Based around a distributed processing network, each nursing station consists of a client/server configuration with internal memory (CD-ROM, magnetic disk, or solid state RAM) to temporarily store the entire health records (in compressed format) for the patients who are resident in the beds monitored by this station. This distributed computerized nursing station is dedicated to a complete hospital wing, or several wings but only controls/monitors a specific number of beds. It is also the centralized location for the PDA docking slots that are interfaced to the nursing station processing unit. A copy of the patient's medical record is maintained at the nursing station until the patient is either moved or discharged. The medical records are downloaded from the ML in compressed format after the patient is admitted to a bed monitored by the nursing station. The ML knows the location of the patient through the unique association of the patient's health card which has been inserted into the bedside PCS, the PCS identification code, and the nursing station/bed hospital architecture.
Refer to FIGS. 11A, 11B, 11C, and 11D, a flow chart that details the process medical personnel would perform in the administration of health care (400), when reading the following description. When care is to be administered, the medical staff picks up the PDA from its docking slot (402) at the nursing station and carries it with them to the appropriate room. Access through confirmation of the user's ID (404) and modification to the patient's electronic medical record is performed through the authorized medical staff's secure signature pen (100) and the PDA display tablet (100) (refer to the next section on Medical Personal Data Assistant) once access to the network has been granted (406). Initially, upon admittance (408), the patient's health card is inserted into the PDA (410) to determine the patient's present (or most recent) medical status and any further supporting medical history data that is relevant (412). This is necessary because even though the patient's medical record has been transferred from the ML to the appropriate nursing station, additional health care may have been administered since the latest update to the patient's archived record i.e. ambulance personnel, on the way to the hospital, could have administered medication which has been documented on the patient's health card. If the patient is already under care in the hospital, the patient's medical record is simply accessed from the nurse's station (440.). The medical personnel then updates the medical record in accordance with the administered health care (414). The PDA automatically transfers the modified health record or portions thereof to the PCS via the wireless/IR communications link (102). These timely updates are conducted in digitally compressed format and the modified data is transferred to the appropriate nursing station (416) and linked with the patient's complete medical record temporarily located here. This periodic updating ensures that the health records are maintained in a timely and efficient manner and resolves the issue that the PDA may be separated from its docking slot for a long period of time due to the possibility of other medical emergencies that require the attention of the administering medical personnel.
When the physician or nursing staff return to the nursing station (418), the medical personnel signs their signature on the PDA tablet display (420) with their personalized signature pen. Validation of their signature (422) with the pen's internally stored master signature, authenticates that 1) this individual is an authorized user and 2) that the changes to the health record(s) can now be formally accepted by the nursing station server system. The PDA is placed in a docking slot (424), and the health record(s) data that has been transferred previously to the nursing station is checked for completeness (all modified data pertaining to any patient's health record have been transferred) and that these modifications can now be officially accepted (426). If there is additional data to transfer, this is accomplished automatically in compressed format through the wireless or infra red communications link, integral with the docking slot. The PDA's battery pack is also recharged when placed back in the docking slot. The PDA is then officially declared free for use again by other medical staff. Periodically, the ML is also updated (428) with the most recent health care status for each examined patient. The data within the health records are compressed first before transmission to the ML. This modified data is held in a temporary record file (430) separate from the original health record though linked to it. This periodic updating of the ML facilitates the capability of external users, such as general practitioners, to access their patient's files to determine the latest health care status. This periodic update time is entirely programmable, and will vary from hospital to hospital, dependent on administrative policy.
The modified electronic health records are maintained at the nursing station until the patient is discharged from the hospital or moved (432) to another location that is controlled by another nursing station. Upon patient discharge, the patient's complete updated electronic health record is transferred back to the master library (434) in compressed format and replaces the original record resident there (the original record is replaced with the new one and the temporary record file destroyed) (436). If hospital policy dictates that past records are to be kept or changes to the original be archived, the original health records are stored as well. When the patient is discharged from the hospital, at the last control point, their health card is updated (438) with the particulars of the most recent administered health care. This is accomplished through a health card writer device that is present at this discharge location. The health card always remains with the individual to facilitate home health care services with medical personnel that may administer health care externally from the hospital.
Because the electronic health record is based on pre-established formats that are resident in the PDA (especially nursing charts), it is very easy to determine changes or additions to patient health records that contain the original information. Changes to patient medication or care are easy to determine through software comparison means, and as a result the nursing station server extracts this information and automatically indicates to the nursing staff, changes that have occurred with respect to the patient's administered care. As a fail safe check these changes are highlighted at the nursing station. The nursing staff acknowledges that these changes have been recognised by entering an acknowledgement check in the patient's modified health record.
Medical Personal Data Assistant (PDA)
The PDA (100) will replace the paper clipboard and allow the user to interface to an electronic database. Patient information is loaded to/extracted from the PDA. All the information passed to/from the ML or the nursing stations is in data compressed format thus enabling the transfer of video images i.e. X-rays to the bedside PCS. The following items identify specific features that are functions of or available options that make this PDA technology especially suited for this application:
(1) conversion of hand written material into neat text with word processing features to edit what has been written.
(2) electronic table of contents facilitating ease of data search and retrieval. Integral medical forms facilitating data entry.
(3) interface with a separate docking unit where information is exchanged between the pen based computer and the distributed processor at the nursing station. This is accomplished through an infra red or wireless communications link. Recharging of the integral battery pack is also implemented when the pen based computer is resident in the docking slot.
(4) voice annotation to modify or correct pen entered data. Voice entry through a head set or through an embedded microphone would effect a hands free data entry operation.
(5) built-in paging capability to receive messages from an external source, i.e. hospital emergency services.
(6) an integral PCMCIA slot(s) that enables the interface with the health card and any other PCMCIA compatible cards.
To enable interaction with the electronic medical record resident on the patient's health card or the stored patient record transferred from the ML to the appropriate nursing station, pen based computer or Personal Data Assistant (PDA) technology (100) is utilized (reference FIG. 6). Each PDA has been assigned a software identification code that is continuously monitored while the PDA is resident in its docking slot located at the nursing station. This PDA technology contains PCMCIA slot(s) that are used to read and/or update the patient's health card. When the health card is read, the data is suitably decompressed before viewing on the PDA. When health care is to be administered, the patient's health card is inserted in the pen based technology and the health status/history viewed. The examining personnel then adds to these electronic medical records, via the PDA technology, in accordance with the present diagnosis or medical status update i.e. the present examination data area is modified. This new information is entered through the PDA technology by simply writing as normal on the pen display tablet or entering information into pre-defined electronic medical forms or charts. If further information is required that is not resident on the patient's card, the patient's medical record temporarily stored at the nursing station is accessed through the patient's PCS to acquire further data. This information is transferred in digitally compressed format from the nursing station to the unique PCS that has requested the additional information and then further onto the pen based system via wireless communications or broadband IR communications (102). The additional information is then decompressed for viewing purposes. If this additional information has been that of a high quality medical image, the PDA requests the viewing of this data on the patient's monitor to take advantage of its enhanced resolution. In the case where medication has been assigned, a validity check is performed against any present patient medication (as indicated in the emergency data area of the health card), to ensure against medication incompatibilities. This check is accomplished with respect to a pharmaceutical database maintained in the ML.
FIGS. 12A and 12B represent a flow chart that describes the identification and verification (442) process that occurs when medical personnel initially attempt to gain access to the internal medical information network for the use of and modification to patient's electronic medical records. To ensure authorized personnel are only allowed access to the internal medical information network, a secure signature pen (104) is used. This is an unique pen or stylus which each user is allocated in order to access medical information through the network This pen contains an internal memory (Dallas Semiconductor) with an encrypted replica of the personal signature of the medical personnel, which once validated by the system, allows access to the network. This replica of the user's personal signature is stored in the signature pen's internal memory in digitally compressed format that is transferred to the PDA when the pen is initially touched to the PDA tablet (444). Personnel signature data files of all authorized users using that particular nursing station are stored on location at the nursing station's file server system for validation purposes. The user's signature replica, having been stored in the PDA, is transmitted to any PCS located at the bedside through either the wireless or broadband IR communications link (102) and then relayed onto the nursing station (440) where it is decompressed for comparison validation purposes. This transfer process of the user's signature replica will usually occur at the first patient's bedside that the medical personnel (nursing staff or physicians) is administering health care to. If a comparison match does not occur after searching all the stored signatures at the nursing station (448), a search of the master signature list (450) within the ML is initiated. This occurs when a visiting specialist, likely located in another region of the hospital, is administering health care to a patient that is not resident in their area. The master signature list at the ML however, contains signature data on all authorized users for the overall hospital. Once validation has occurred (452), an indication is transferred to the ML administrative software management system that network access has been granted to that user (454). There is established an unique one to one relationship between the medical personnel, due their digital signature, and the PDA because of its software ID. This facilitates the establishment of an unique audit trail for the network by tracking the authorized personnel granted access and at what time this access was initiated (456).
All the appropriate standardized medical forms are stored in the PDA's memory and accessed through a simple menu window. Custom forms are capable of being generated if required. The data entry is kept to simple operations to reduce the amount of handwritten text to minimize errors and enhance performance. Each time the PDA is loaded into its docking slot located at the nursing station its software clock is synchronized with the clock of the master library. This ensures an accurate time audit trail being associated with each patient's health record as to when it was changed/updated and automatically entered into the master library. The PDA also has the capability of containing a paging unit eliminating the need for medical personnel to carry a separate paging device. Personal messages are routed to the appropriate medical staff because the system, through the unique one to one relationship established between the user's pen and the PDA, knows the location of that individual.
Electronic Medical Records
Integrated with the PCS as previously mentioned, is a smart card reader/writer unit. The intent is to provide a complete electronic medical record in digital compressed format supplying as much medical information on the patient as possible i.e. blood type, vaccination and medication data, diabetic controls for blood sugar levels, allergy data especially when drug related, etc.
The health card's memory is to be divided into explicit regions.
(1) Personal Data--personal ID that contains a video compressed image of the individual to authenticate the user, other personal data (name, address, next of kin, date of birth, etc.), insurance coverage, etc. Once user verification has been ascertained, access to the remaining medical data is granted.
(2) Emergency Data--contains data of life saving importance i.e. blood type, allergies, any medication, immediate medical history relating to patient status such as diabetes, Parkinson's disease, dialysis treatment, etc. This data is available to anyone who has a card reader unit such as in an ambulance or carried by a home health care service individual.
(3) Medical History--contains the medical history of the patient including past diseases, injuries, operations, etc. and associated treatments. This area, once access has been granted through item 1), is further sub-divided into medical disciplines i.e. general practitioner data, specialist and surgeon data, psychiatric data, etc. each accessible by only those authorized to its access. Pertinent video images relating to radiology, X-rays, etc. are stored through digital video compression techniques.
(4) Present Examination Data--documentation of the actual examination, who performed it, where and when, and the diagnosis with the prescribed medication, if any. This area is automatically entered into the medical history area when a new examination occurs. A comparison of past examinations can be performed to determine if the patients state of health has improved or deteriorated.
The entire operation (access and data retrieval) with respect to the use of the health card, is protected with a security envelop. Medical data is fully encrypted, data integrity is assured, access is rigidly controlled, and access audit trails conveniently maintained.
The following items/systems can be considered as preferred options to the master library, the medical information network, and the PCS.
The Regional Medical Library
Remote from the hospital sites, a regional medical library is to be established. These are large data storage complexes (202) based around a large computer system (Cambridge, Convex, IBM, etc.) and mass memory storage (204) (Storage Technology, Ampex, EMASS, or Metrum Peripheral Products). Refer to FIG. 7A and 7B. This regional library is capable of providing compression services (video compression systems (206) are available from IBM, DEC, SGI, etc.) to suitable quality levels determined by the application i.e. movie video distribution, educational videos, medical training packages with high resolution medical images, etc. As a result, the regional library contains several compression services in software and hardware forms (C-Cube, Optibase, XING, Apple, etc.) and thus can take advantage of the latest development in compression technology. Compression capabilities for textual and graphical data also reside in this regional library. These compressed products are then distributed via video servers (226) and high speed memory buffers (228) back to the hospitals' master libraries, to third party users such as medical training universities, to clinics/laboratories, physician offices (208), and even to patient's residences if necessary. This distribution is via DBS, fiber optics, coaxial cable, wireless means, or twisted pair telephone cabling depending on the communications capability at the user facility and the amount of data and the required bandwidth necessary to implement distribution.
This regional library also has the capability to allocate dedicated services to specialized medical research fields (210) i.e. cancer, diabetes, altziemers, etc. This is accomplished by acquiring all the relevant information on the specific field from all the interconnected hospital master libraries. Applicable confidential patient identification has been purged from this data, leaving only the relevant medical data. A similar software management and data search/sort (Fulcrum's SearchTools) capability as described for the hospital master libraries is available to satisfy requests by research oriented users. Each user pays a per use access fee for usage of these research oriented databases.
This regional library also acts as a distribution hub for the dissemination of new medical information or electronic medical literature in compressed format. This is especially relevant to large hospital organizations that require the dissemination of information to all their member hospitals. For instance, new information relating to new drug types (224) and their use and application is easily distributed automatically to interested parties i.e. users have been screened into specialized categories such as cancer related issues. These authorized users include registered hospitals, medical clinics, and the offices of general practitioners with the distribution of this data via DBS, fiber optics, coaxial cable, or telephone cabling (212). Typical data such as this likely contain images, so the data is compressed to permit the distribution of video images and to minimize the communication link charges. Other typical types of information include data pertaining to new prothesis components, literature relating to new/changes to medical coverage insurance plans, changes to legal/governmental medical policy, etc. The regional library becomes a centre for the dissemination of all medical related information. This encourages the expansion and use of the overall medical network system.
The regional library contains software authoring tools (Video for Windows*, Actionmedia II*, Indeo*, Adobe*, Quicktime*, etc.) to allow the production of medical educational and training materials. Hardware to generate CD-ROM masters (214) to assist in the distribution of this training material is also available. This is extremely important with respect to the association between the regional library, the offices of the general practitioners, medical clinics, lobbies of hospitals, and other medical facilities. A medical diagnostic node (information kiosk) (216) is to be established at each location consisting of a PC, a monitor, and a CD-ROM player. Through an interactive menu, an interested user scans through a database to conduct a preliminary self diagnosis, obtain information on specific drugs, their application and any potential effects, nutrition and dietary data, etc. The intent is to make the user more informed as to their own medical problems and related health care. To complement this capability, a phone in line known as HealthTel (218), is staffed by expert medical personnel to assist in further diagnosis or for the general dissemination of medical information.
In association with the regional library (not necessarily at the same location) is a centralized warehouse for the distribution of all medical supplies or consumables. This warehouse (220) is linked with the hospitals' master libraries or an organization's overall inventory control system to automatically order, distribute, and invoice for the requested medical merchandise. This is effected through the use of standard Electronic Data Interchange (EDI) file formats for order forms, invoices, etc.
The regional library also contains a maintenance diagnostic centre (222). From this facility a maintenance technician is capable of accessing any hospital master library and indirectly any PCS unit, and invoke the running of maintenance diagnostics. Thus from a remote facility, equipment servicing is accomplished to assist local maintenance personnel in the diagnosis of equipment failures.
Thus it is apparent that there has been provided in accordance with the invention that fully satisfies the objects, aims and advantages set forth above. While the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art in light of the foregoing description. Accordingly, it is intended to embrace all such alternatives, modifications and variations as fall within the spirit and broad scope of the invention.


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EXCLUSIVE: Mark Wahlberg Tells Us: There's No Way I'll Let My Kids Get Tattoos
The star of The Other Guys is OK with the fact that he has tattoos, but when it comes to his four kids, it's a case of "do as I say, not as I do."
Mark Wahlberg has never been shy about his own tattoos, flashing them whenever he takes his shirt off (which is a lot, by the way!) and he is comfortable discussing them when someone asks about his body ink. But when HollywoodLife.com caught up with him at the New York premiere of his new film The Other Guys and asked the 39-year-old actor what he would say if one of his four kids ever wanted to get one? His answer was only two words: "Hell no!"
Hmmm… Four kids (Ella Rae, 7, Michael, 4, Brendan, 2, and Grace, 7 months, with wife Rhea Durham), four tattoos (Sylvester the Cat with Tweety Bird on his left ankle; Bob Marley on his left arm; "Wahlberg" superimposed over "MW," along with his birthdate and his parents' initials on his right arm; and a rosary tattoo around his neck), four best buddies on Entourage (the HBO hit he produces)… it seems the number four is pretty big in Mark's life.
We're not sure what that means, but we're guessing that if he gets another tattoo, it'll totally upset some mysterious cosmic balance. Here's a word of advice, Mark: if you don't get any more tattoos, it might end up saving the world — and it'll be easier to tell your kids to stay ink free!

subset: commoncrawl


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Posts Tagged 'Battle'
They say it isn't the destination that matters, rather that it s the journey that truly matters most. This is true when we all arrive at where we want to be, reach goals we want to reach and reminisce about all the things we did, mistakes we made and people we met along the way. […]
Filed under: Uncategorized | 11 Comments
Tags: Always, Always Missed, Angel, Angel on earth, Battle, Bittersweet, Brain Tumours, Breast Cancer, Cancer, Cry, Death, Eternal flame, Family, Five Year Battle, Forever, Grief, Grieve, Heaven, Hero, Hope, I miss you, Is, Loed Ones, Loss, Love, Memories, Missing you, Mother, Mother's Day, Mum, Never Forgotten, Never give up, Never let go, One of a kind, Pain, Peace, Sadness, Suffering, Tears, Touched my heart, Unique, was, Wish you were here


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Pagan rehabs with Buffalo
The New York Mets today announced that OF ANGEL PAGAN will join the Buffalo Bisons today as part of his major league injury rehab assignment. The Bisons face the Gwinnett Braves at 7:05 p.m. at Coca-Cola Field.
Pagan, 29, was placed on the disabled list on April 22 with a strained left oblique. He has already played six games with the Single-A St. Lucie Mets of the Florida State League as part of his injury rehab assignment. With St. Lucie, Pagan has averaged .261 (8-23) with a double, a home run and two RBI.
This will be the second time in his career that Pagan has rehabbed with the Bisons. The outfielder joined the Herd for a three-game stint, May 12-16, 2009, while recovering from off-season elbow surgery. He hit .286 (4-14) with two triples, two RBI and two runs scored in those three games. In his Bisons debut on May 12, he hit a two-run, walk-off triple in the bottom of the 11th inning of a 4-3 win over Gwinnett.


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Remember when the Wall Street Journal told us crime was so bad in Mexico that even the Mayor of Monterrey, Fernando Larrazabal had fled and re-located his family to the Dallas area? (I found out it was to Las Colinas, and y'all got mad at me. I also found out on a visit to La Paz, Mexico, in November that Sr. Larrazabal wanted to be closer to her family here in North Texas.) Crime there is way out of control; the city is caught in a war between two drug cartels, the Gulf Cartel and the Zetas. A U.S. Federal ICE agent was recently murdered, and the violence could be spreading to the U.S.
I talked with my landscaper, who used to drive through Monterrey on the way home to see his parents in Mexico: he told me he no longer drives through Mexico.
"It's terrible," he says. "My wife, she is afraid. They are killing people in Monterrey every day. EVERY day!"
It's the drug cartels, he told me, and he blames the Mexican government for not wanting to accept any assistance from the U.S. There have been 350 killings in Monterrey this year, which is the third most populous city in Mexico with 3.7 million people. August 18 the body of the mayor of nearby Santiago, Edelmiro Cavazos, was found on the outskirts of Monterrey, an industrial center with close U.S. business ties. Two doctoral students have been killed, guests at a Holiday Inn kidnapped, and the cartels killed two bodyguards right in front of a school. Many Americans and even some wealthier Mexican are out of there and ending up in Texas — so in a perverse way, this could be good for our property values.
I still recall the story of a rancher who was kidnapped and held hostage for over a year in a box, beaten, shot, barely fed, all to extort ransom money from his American-born wife. Guess where this happened: San Miguel D'Allende. On the show, the couple, who were both in real estate, said initially they were asked to keep quiet about the kidnapping for fear of the damage it would do the to real estate community.


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Junior Reece Wilson scored in the 84th minute to tie the game at 1-1. Junior Thomas Obasi finished the game in the 96th minute with a golden goal that gave the Blue Devils a 2-1 victory over Fairleigh Dickinson. The victory gives the Blue Devils a 9-8 record on the season and a 6-3 mark in Northeast Conference action.
FDU's Nico Wright scored for the Knights in the 5th minute of the game. Wright scored off a one-on-one with junior keeper Anthony Occhialini. Occhialini stopped the first shot, but Wright grabbed the rebound and scored to give his team the lead.
The Knights led for more than 75 minutes, until Wilson found the net.
Wilson moved down the rightside of the field and then shot back across the net and beat the keeper into the lower left corner. That strike came with only six minutes left in the game.
Six minutes into overtime he contributed to the go ahead goal with a pass to Obasi. Obasi took the ball and delivered the golden goal into the lower left corner of the net.
Occhialini was solid in the net. He posted four saves and allowed only one goal in 95 plus minutes of action. He improved to 9-6 in the net on the season.
The victory gives the Blue Devils 18 points on the season. That ties them with Monmouth for the most in the NEC. If the regular season ends with those two teams tied atop the standings, the Blue Devils hold the head-to-head advantage, having defeated Monmouth earlier this season.
The Blue Devils host St. Francis (NY) on Friday in their final regular season match of the season.


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Army Staff Sgt. Josh Olson trains with a .22-caliber rifle at Fort Benning, Ga. Olson, a member of the Army Marksmanship Unit's international rifle team, spends about 15 hours training each week and participates in between 10 and 15 national and international matches each year. Olson is the only wounded warrior in the AMU.
Story by Caroline Gotler
Date: 03.27.2009
FORT BENNING, Ga. - An infantryman for most of his Army career, Army Staff Sgt. Josh Olson never dreamed he would someday become an internationally ranked shooter with the Army's World Class Athlete Program.
But everything changed for Olson after losing his right leg in an attack during a deployment to Iraq in 2003.
"I was going to get out of the military," Olson said. "I was an infantryman, and I knew I couldn't do that anymore, so I just wanted to get out. Then this opportunity came up and it gave me a renewed sense of duty and honor."
That opportunity was a call from U.S. Army Marksmanship Unit recruiters to Walter Reed Army Medical Center in Washington, D.C., where Olson was undergoing physical therapy. Olson had been participating in a program that provides hunting, fishing and outdoor sports events to recovering Soldiers. When medical center officials asked if any soldiers were interested in an AMU recruiting trip here, Olson jumped at the chance.
"When I found out I could do this, I was like, 'Yeah, absolutely, let's do it,'" he said. "You can't be in the fight, but you have the opportunity to help Soldiers who are going to fight. So I'm still contributing, just in a different way."
Since joining the AMU international rifle shooting team in 2005, Olson has risen rapidly through the world of shooting. He competed in the 2006 International Paralympics Committee World Championships and the 2007 Oceanic Games, and earned a spot as an alternate on the 2008 Paralympics team. Today, he's aiming for a spot on the U.S. shooting team at the 2012 Paralympics in London.
"As far as he's come in such a short period of time is amazing," Army Sgt. 1st Class Jason Parker, Olson's AMU teammate, said. "He came to us with no international shooting experience and in three years' time, he was an alternate. We expect him to be up on the medal podium in another three years."
To qualify for the Paralympics, Olson will need to shoot at least three qualifying scores in international matches over the next four years. He expects to have shot at least two by the end of this year.
Olson's dedication and positive attitude have set an example for the entire unit, Parker said.
"He's always had a positive attitude," Parker said. "That's one of the great things about him. You look at him and sometimes you can see that he's not feeling great, but he's out there putting out 100 percent. He's a great motivator. He's contributed to our mission in every possible way."
Olson said that knowing his AMU teammates are counting on him helps keep him motivated during tough times.
"On days I don't want to get up and come to training and I'm kind of feeling sorry for myself, I think, 'Hey look, there are people counting on you, so you need to get out there and work your butt off,'" he said.
He credits his injury with allowing him to serve and represent his country in new ways.
"Without me getting injured, I would have never gotten the opportunity to come here and shoot," he said. "Being wounded might have closed some doors, but it opened others in other places. And this is one of the places it opened up - for me to be able to compete, shoot and train troops and still be contributing to the war effort.
"Being a disabled veteran, to go out and wear U.S.A. on your jacket and to hear them announce you - 'Now shooting for the U.S., Josh Olson' - that's a pretty big deal. I can't represent the U.S. as a deployed Soldier, but now I represent them on a whole new battlefield, the athletic field."


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Pope's Visit to Cuba: Historic Visit at Vital Time
March 25 issue preview of the Holy Father's trip this week.
WASHINGTON — Pope Benedict XVI's pilgrimage to Cuba March 26-28 has demonstrated the breathtaking power of the universal Church to erase borders.
When the bishop of Santiago de Cuba, the easternmost city in Cuba, realized he needed more priests for the expected surge in confessions around the Holy Father's visit, he turned to his northern neighbors in the Archdiocese of Miami.
No matter that relations between the United States and Cuba remain tense, as they have been for more than 50 years. "Reconciliation" is the theme emphasized by the Church in both countries.
Archbishop Thomas Wenski of Miami recently shared Bishop Dionisio Garcia's request with a gathering of archdiocesan priests, according to Father Juan Sosa, the Cuban-born pastor of St. Joseph Church in Miami Beach and coordinator of the annual "Ecclesiastical/Lay Encounter," which brings Catholic priests and laypeople from Cuba together with Catholic Cuban exiles.
"I'm already going," said Father Sosa. "But I think any priest with a passport who can get the paperwork done [for a visa] and has two weeks available is welcome to help."
More than 300 pilgrims from the archdiocese — together with an undetermined number of priests — will travel by chartered plane with Archbishop Wenski to participate in Pope Benedict's island visit, which follows the Holy Father's three days in León, Mexico.
Other U.S. Church leaders greeting Pope Benedict include Cuban-American Bishop Octavio Cisneros, an auxiliary bishop of Brooklyn, N.Y., representing the U.S. Conference of Catholic Bishops (USCCB), together with Bishop Gerald Kicanas of Tucson, Ariz., chairman of Catholic Relief Services; Bishop Richard Pates of Des Moines, Iowa, chairman of the U.S. bishops' Committee on International Justice and Peace; and Bishop Eusebio Elizondo, the Mexican-born auxiliary bishop of Seattle.
The Holy Father's pilgrimage to Cuba honors the 400th anniversary of the discovery of Our Lady of Charity (La Virgen de la Caridad), a miraculous statue of Mary cradling Jesus found floating in a bay in northeastern Cuba by three fishermen in 1612. The 16-inch-tall statue stands today in the Basilica of El Cobre, a mountainous mining town near Santiago de Cuba.
Our Lady of Charity was named the patron saint of Cuba by Pope Benedict XV in 1916. Pope John Paul II crowned the Virgin and Child during his visit to Cuba 14 years ago.
In honor of the jubilee, a replica of the Virgin was carried across the island between 2010 and 2011, allowing millions of Cubans to see her. She is venerated by Cubans of all backgrounds, even by followers of Santeria, a religious tradition of African origin that was developed in Cuba. Her shrine has been the island's most sacred site for pilgrims, many of whom leave votive gifts. Ernest Hemingway offered his 1954 Nobel Prize for literature to the Virgin, having written his best-known novel, The Old Man and the Sea, in Cuba.
Still Repressive
Pope Benedict's trip begins with a March 26 Mass in Santiago de Cuba's Revolution Square. The next morning, he will pray at El Cobre Basilica, then fly to Havana, where he is scheduled to meet with President Raul Castro. On March 28, the Holy Father will celebrate Mass in Havana's Revolution Square.
The Holy Father's pilgrimage comes at a time of significant uncertainty about the country's future and great suffering for many who advocate greater freedom.
The communist regime that governs Cuba has allowed the Church a measure of autonomy to minister to the poor and sick, to preach the Gospel within Church space, and to maintain Church buildings — some initiatives first proposed by Pope John Paul II.
"Pope Benedict's visit is an expansion of Pope John Paul II's trip," Father Sosa observed. "It is a growth, or development, along the same path."
He explained, "Pope John Paul publicly asked for some specific things, including more access to the people and more access to education, as well as for means of communication for the bishops. We still are not allowed much access to education, but we have missionary programs, catechism and library programs in each diocese on the island."
During the first 30 years of Fidel Castro's revolution, the Church experienced relentless persecution. Most priests were driven from the island, Church property was nationalized, Cuba was officially atheistic, believers were mocked and marginalized, and state policies such as abortion on demand for anyone of any age was considered evidence of Cuba's "progressive" health system.
Today, the regime allows the Church leadership a measure of freedom. For example, Cardinal Jaime Ortega, archbishop of Havana since 1981, received permission for the jubilee procession of Our Lady of Charity. The cardinal also won approval to build a new seminary (the cornerstone was blessed by Pope John Paul II), inaugurated in late 2010 — the first new Church construction since 1959, when Castro took power.
Two years ago, the party leadership sought the cardinal's assistance to defuse tense stand-offs between non-violent women, known as the Ladies in White (Damas de Blanco) who marched on Sundays after Mass, and angry mobs mobilized to jeer at the women. They march to protest the fate of jailed male relatives, most of them political prisoners, locked up for daring to demand greater respect for human rights.
In 2010, after a political prisoner, Orlando Zapata Tamayo, died as the result of a prolonged hunger strike, the Ladies in White grew more defiant, and their tormentors became more aggressive, blocking them from their silent, weekly walks. Images of these near riots were broadcast internationally.
Cardinal Ortega stepped in to protect the group, in a gesture that resulted in the government eventually releasing more than 100 prisoners, although only a few were allowed to remain in Cuba, and most were forced with their families into exile in Spain. At least one prisoner, Ariel Sigler Amayo, who became paralyzed in jail as a result of poor medical care, was, after prolonged suffering, allowed to come to the U.S. for treatment, where he has made an apparently miraculous recovery.
So, from one perspective, the Church in Cuba has forged a path between conflict and concession in dealing with the Cuban government in order to more effectively defend the powerless, including prisoners.
Yet the Cuban regime remains oppressive and intolerant of dissent — a fact that the Pope must address during his visit, say many devout Catholic Cubans in the U.S. and Cuba.
"My fear," said German Miret, a lay leader in Miami who left Cuba as a young Catholic activist in 1962, "is that the regime shows Pope Benedict a 'Potemkin village' in Cuba — that's a phrase from Russian history, when Catherine the Great was shown wonderful villages in the Crimea by her generals just so she would think life was good there. Reportedly, a similar effort is under way around El Cobre, where poor people who live in old houses without electricity are being evicted and the houses leveled so the Pope won't see the poverty."
Miret would not consider taking the trip to Cuba, although he is an active parishioner in the Archdiocese of Miami. "I don't want to ask permission to go back to my country. As long as there's a communist system, I'm a political exile; and an exile can't go back to a place where he would be persecuted."
'Our True Liberation'
The ongoing tension between the regime and its opponents will invariably result in more clashes.
Only last month [Feb. 20], Bishop Garcia, who also heads the Conference of Cuban Bishops, had to bring vans to the basilica in El Cobre to free 14 Ladies in White who took refuge in the church when threatened by police. One of the women, trying to get to the church, was detained by police and later suffered a miscarriage, which she blames on police brutality.
According to Christian Solidarity Worldwide, in recent weeks, Cuban political police have arrested Ladies in White and other human-rights activists across the island as they tried to attend Sunday Mass. Protestants as well as Catholics are being targeted, the organization reported.
As a result of this continuous harassment, many believers in Cuba and abroad are beseeching Pope Benedict to meet with representative Ladies in White and to speak out against violations of human rights.
The award-winning Cuban-American writer Carlos Eire, who holds the chair in Catholic studies at Yale University, wrote a moving open letter to the Holy Father, posted March 5 at National Review Online.
"Your public acknowledgment of the Ladies in White could change the course of history," Eire wrote. "They pray for that; we all pray for it too, along with them. I, a beggar, driven from my homeland 50 years ago, join the bold Ladies in begging."
Miret agrees with Eire. "I'm afraid the government will look good because it is willing to honor the Pope, but human rights won't be brought up. I do not oppose the Pope's visit — the people need him — but I am against the Holy Father ignoring what is wrong," explained Miret. "He should meet with the Ladies in White."
The leading Catholic democracy activist in Cuba, Oswaldo Paya, hopes to be present for the Pope's visit. As the founder of the Christian Liberation Movement in the 1980s, he led a grassroots effort, the Varela Project, which collected approximately 25,000 signatures from Cubans requesting a referendum on basic liberties such as the rights to expression and association, free elections and free enterprise. Much of the movement's leadership was jailed in 2003; Paya is under 24/7 surveillance by Cuban security operatives.
He confirmed that the communist government is aggressively trying to intimidate regime opponents. By telephone from Havana, he told the Register: "In a very nasty style, like the Cultural Revolution in China, police are using terror against families who cannot defend themselves, especially the Ladies [in White] and government dissidents. They are saying we are not allowed to go to the ceremony of the Pope."
"But," Paya continued, "the Pope is unity. The Pope is charity. This message is very important to us because God is our true liberation; and as we take risks for freedom, God is always reminding us that we have it, in us through him."
Said Paya, "Everybody is doing his own best in the world, and the Catholics who don't know each other — we are united; and the Pope is the sign of that unity."
The Register went to press prior to the Pope's journey to Mexico and Cuba.
Look for live coverage at NCRegister.com.
Victor Gaetan writes from Washington. He received the
2011 Catholic Press Association's top award for a Register series on Cuba.


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Twilight Yoga at the Light
May 6, 2019 @ 7:00 pm - 8:00 pm
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Experience the serenity of Yoga with Mary Veal on the Lighthouse Deck at sunset every Monday. This is an all levels class and beginners are welcomed and encouraged! $10 per person. Bring a yoga mat, water bottle and a flashlight. Meet at the Museum ten minutes prior to start time, class is weather dependent – please check website for updates and future start times.
Jupiter Inlet Lighthouse & Museum, 500 Captain Armour's Way, Jupiter, FL 33469